摘要
目的探讨血必净注射液治疗脓毒症合并急性肾损伤(AKI)的疗效及对T淋巴细胞亚群、血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、金属蛋白酶组织抑制剂-1(TIMP-1)水平的影响。方法使用随机数字表法,将收治的52例脓毒症合并AKI患者分为2组,对照组(26例)采取常规治疗+连续性肾脏替代治疗(CRRT),联合组(26例)采取血必净注射液+CRRT治疗。观察并比较2组患者治疗前后血清炎症因子、T淋巴细胞亚群、NGAL、TIMP-1水平变化及临床疗效等。结果与治疗前相比,治疗后2组各项血清炎症因子水平明显降低,治疗后血清炎症因子水平组间比较显示,联合组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和超敏C反应蛋白(hs-CRP)水平更低(P<0.05)。联合组治疗后的CD3+、CD4+和CD4+/CD8+水平明显高于对照组(P<0.05)。2组患者治疗后的血清TIMP-1及NGAL水平均较治疗前明显降低(P<0.05)。组间比较,联合组治疗后的血清TIMP-1及NGAL水平更低,治疗1周后的APACHEⅡ评分明显更低(P<0.05)。联合组的尿量恢复时间、ICU住院时间均明显短于对照组(P<0.05)。结论血必净注射液联合CRRT治疗脓毒症合并急性肾损伤可有效降低NGAL和TIMP-1,改善T淋巴细胞亚群指标,减轻炎症反应,从而提高临床疗效,改善患者预后。
Objective To investigate the efficacy of Xuebijing Injections in the treatment of acute kidney injury(AKI)due to sepsis and the effects on T lymphocyte subsets,serum neutrophil gelatin associated lipocalin(NGAL),tissue inhibitor of metalloprotei-nase-1(TIMP-1)level.Methods Fiftytwo patients with sepsis complicated with acute kidney injury were collected and divided into 2 groups according to random number table method.The control group(26 cases)were treated with conventional therapy+continuous renal replacement therapy(CRRT),and the combined group(26 cases)were treated with Xuebijing Injection+CRRT.The changes of serum inflammatory factors,T lymphocyte subsets,NGAL,TIMP-1 levels and clinical efficacy were observed and compared between the 2 groups before and after treatment.Results Compared with before treatment,the levels of serum inflammatory factors in the 2 groups after treatment were significantly lower.After treatment,the levels of serum inflammatory factors were compared between the groups,the results showed that the interleukin-6(IL-6),tumor necrosis factor(TNF-α)and high sensitivity C-reactive protein(hs-CRP)in the combined group were significantly lower(P<0.05).After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the combined group were significantly higher than those in the control group(P<0.05).The serum TIMP-1 and NGAL levels of the 2 groups after treatment were significantly lower than those before treatment(P<0.05).The levels of TIMP-1 and NGAL in the combined group were lower than those in the control group,and the APACHE-Ⅱscore was significantly lower after one week of treatment(P<0.05).The recovery time of urine volume and ICU stay in the combined group were significantly shorter than those in the control group(P<0.05).Conclusion Xuebijing Injections combined with CRRT in the treatment of sepsis complicated with acute kidney injury can effectively reduce NGAL and TIMP-1,improve T lymphocyte subsets and inflammatory reaction,so as to improve the clinical efficacy and prognosis.
作者
黄赟
刘亚军
王智兰
全超
张勤芹
张浩
缪翠维
HUANG Yun;LIU Yajun;WANG Zhilan;QUAN Chao;ZHANG Qinqin;ZHANG Hao;MIAO Cuiwei(Department of ICU,Nantong Hospital of Traditional Chinese Medicine,Nantong 226001,China)
出处
《西北药学杂志》
CAS
2021年第3期475-478,共4页
Northwest Pharmaceutical Journal
基金
2018年度南通市中医医疗联盟课题(编号:TZYK201816)。
